| ObjectivesInvestigation in patients with acute myocardial infarction pre-hospital delay present situation; To explore the influence factors of pre-hospital delay; Analysis to investigate the optimal emergency procedures in patients with st-segment elevation myocardial infarction door to balloon time, always save time and the value, the influence of specification of emergency nursing process, reduce hospital delays, improve the rescue efficiency.MethodsThrough the investigation methods and medical record tracking methods in October2012-March2013at the teda international hospital emergency in cardiovascular disease, within12h of stroke onset accept direct percutaneous coronary intervention (PCI) of240patients with STEMI patients investigation and description; Using single factor analysis and multivariate stepwise regression to240cases of the object of study the influence factors of pre-hospital delay is analyzed. Adopt the method of random divided into process optimization group and normal group,131cases and109cases respectively, and the process optimization group of patients with the emergency treatment process according to the new treatment, and preoperative preparation, conventional group of patients continue to use the previous conventional emergency process. Recording, collection of two groups of patients D2B time, emergency stop time and total hospitalization days, after6months follow-up cardiac adverse events, including myocardial infarction, angina pectoris after infarction, cardiac death, heart failure in four aspects. Using two independent sample t-test to statistical analysis of results, comparing two emergency process of D2B time, emergency stop time, total hospitalization days and the influence of cardiac adverse events after6months.Results1. In240cases of AMI patients, by single factor analysis, timely treatment after the patient is sick is affected by education level, occupation, personal income, medical treatment charge payment, abnormal in time to see a doctor, living ways, cognitive level, pain symptoms and diseases and medical history related to gender, age, marital status, and has nothing to do with the pre-hospital delay; Through multiple stepwise regression further analysis the main factors affecting the onset of AMI patients to see a doctor time as follows:personal income, medical treatment charge of payment, way of living, the onset of pain symptoms and the disease cognitive level.2. Optimization of the emergency treatment process can significantly shorten the patient’s D2B time and total time. Floor department coordination, integrated optimization of the emergency treatment process, and the implementation of the transfer process in the above two aspects is superior to the conventional group. But these two treatment processes in terms of total hospitalization days no statistical significance.3. Follow-up of patients with cardiac adverse events after six months, the optimization process group recurrence in patients after myocardial infarction, infarction, angina pectoris, cardiac death and the incidence of heart failure in four aspects are lower than normal group, the difference was statistically significant.ConclusionIn patients with AMI onset time to see a doctor, the pre-hospital delay time of personal income, medical treatment charge of payment, way of living, the onset of pain symptoms and the disease cognitive level is the main influence factors. Floor collaboration, optimization, standardization of emergency care delivery processes can reduce the patients arriving, shorten D2B time and total time. Should be optimized to emergency patients with AMI treatment process to specification, to develop a set of AMI patients accepts, diagnosis, examination, treatment, care and transport system and process, applied to clinical. At the same time, make the patient and family health education and disease knowledge popularization, let they don’t have to because of illness not understand and concern and delay time of operation, to win time for the patient’s treatment, improve the success rate of rescue. |
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